Among the benefits of the Affordable Care, beyond expanding health care coverage and lowering costs, has been to create more jobs. Bloomberg News reports:

More than 90 new health-care companies employing as many as 6,200 people have been created in the U.S. since Obamacare became law, a level of entrepreneurial activity that participants say may be unprecedented for the industry.

Zenefits, which provides human-resources software and acts as a health-insurance broker for small employers, wouldn’t exist without the law, said Parker Conrad, the firm’s chief executive officer. Since the Affordable Care Act’s inception in April 2013, the San Francisco-based company has grown to more than 900 employees. That makes it the largest firm among dozens that have sprouted in the law’s wake, according to PricewaterhouseCoopers, which issued a report on the trend this week.

The health law, which took full effect in 2014, represents the most dramatic change to the U.S. health system in 50 years. Entrepreneurs, including some from within President Barack Obama’s administration, have founded companies that target employers, health insurers, hospitals, doctors and consumers looking to navigate new requirements and possibilities.

The Affordable Care Act can also increase jobs another way. By freeing people to leave their current jobs with large companies without fear of losing insurance coverage, more people can leave to create new companies.

Despite the many benefits of the Affordable Care Act, large numbers of people remain misinformed. Sara Kliff reviewed this at Vox, noting common misconceptions persisting about the cost of the law,many incorrectly believing that illegial immigrants can obtain coverage, and many still believing that there are death panels.

PolitiFact has looked at the data available so far on the Affordable Care Act. They confirm what I’ve said in many posts on health care reform. ObamaCare is leading to more people being insured, lower costs, and a reduction in the deficit. The various Republican predictions of doom have failed to come about. The one area in which the law failed to meet expectations was the number of people covered due to Republican-controlled states which do not participate in the expanded Medicaid program. Thank-you Republicans for once again showing that you are the anti-life party.

Here is a summary of what PolitiFact has reported:

In 2010 it was projected that by 2019 32 million people would gain insurance, leaving 23 million uninsured (with the uninsured including illegal immigrants who, despite that email from your crazy Republican uncle, are not covered under ObamaCare.) It is now projected that by 2019 27 million will gain insurance, leaving 26 million uninsured. This is largely due to those not receiving access to the expanded Medicaid program in Republican-controlled states.

In 2010 it was predicted that the Affordable Care Act would decrease the deficit by $143 billion between 2010-19. In 2014 the projection was updated to reducing the deficit by $152 billion between 2015-24.

In 2010 the cost was projected to be $710 billion between 2015-19. The updated projection is $571 billion. The lower estimate is due to both reductions in health care costs and decreased spending on the expanded Medicaid program.

PolitiFact debunked that Republican claims that the Affordable Care Act is a jobs-killer.

PolitiFact debunked the Republican predictions of a death spiral in which premiums would become more expensive and younger, healthier people would not purchase insurance: “About 28 percent of customers during the 2014 enrollment period were ages 18 to 34. And there were 70 more insurance companies participating in the 2015 marketplaces than the previous year…”

PolitiFact debunked Republican predictions of increasing premiums, noting a decrease in health care spending. It is not clear to what degree this can be attributed to the Affordable Care Act versus other factors. One aspect that is not measurable is the way in which the culture in health care has changed since Obama began speaking about health care reform, leading health care professionals to utilize resources more economically.

The Affordable Care Act was introduced as incremental legislation which would both increase access to care and reduce costs. It was never expected to lead to universal coverage without further expansion of the plan. PoltiFact looked at those projected to remain uninsured:

Who makes up this group of persistently uninsured? About 30 percent are illegal immigrants, which the law specifically does not apply to. But about 40 to 45 percent are people who will choose not to purchase insurance offered to them either through the marketplaces or through an employer, in many cases because they still can’t afford it. The law exempts people from paying a penalty who have incomes so low they don’t file tax returns.

There is also a coverage gap unintended by those who wrote the law: People who live in states that didn’t accept Medicaid expansion. The law essentially required states to expand eligibility and agreed to pay 100 percent of the expansion for the first three years, declining to 90 percent in 2020 and beyond.

One goal for the future is to provide assistance for those denied care due to living in Republican-controlled states. Further review of the law is needed regarding the 40 to 45 percent who are projected to remain uninsured due to choosing not to purchase insurance offered through the exchanges or employers. Some people are not obtaining coverage due to believing false information spread by Republicans and this problem will hopefully decline as more people see the success of the law. Some were unaware of the tax penalties as they will not experience them until paying taxes due this April 15. This might provide further motivation to obtain insurance.

I recently discussed a flaw in the implementation of the Affordable Care Act in which people who were unaware of the penalties for failing to obtain health insurance might not become aware of this until April, after the closing of the open enrollment period. It would then have been too late for them to purchase insurance. Some Democratic members of Congress were urging the Obama administration to extend open enrollment. Today they have announced a special enrollment period from March 15 until April 30. There are also a number of events, such as loss of coverage, which allow individuals to purchase insurance outside of the usual open enrollment period. Following is the release from CMS:

The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.

For those who were unaware or didn’t understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30. If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

Currently are not enrolled in coverage through the FFM for 2015,

Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and

Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015. If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

This year’s tax season is the first time individuals and families will be asked to provide basic information regarding their health coverage on their tax returns. Individuals who could not afford coverage or met other conditions may be eligible to receive an exemption for 2014. To help consumers who did not have insurance last year determine if they qualify for an exemption, CMS also launched a health coverage tax exemption tool today on HealthCare.gov and CuidadodeSalud.gov.

“We recognize that this is the first tax filing season where consumers may have to pay a fee or claim an exemption for not having health insurance coverage,” said CMS Administrator Marilyn Tavenner. “Our priority is to make sure consumers understand the new requirement to enroll in health coverage and to provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable coverage this year.”

Most taxpayers, about three quarters, will only need to check a box when they file their taxes to indicate that they had health coverage in 2014 through their employer, Medicare, Medicaid, veterans care or other qualified health coverage that qualifies as “minimum essential coverage.” The remaining taxpayers – about one-quarter – will take different steps. It is expected that 10 to 20 percent of taxpayers who were uninsured for all or part of 2014 will qualify for an exemption from the requirement to have coverage. A much smaller fraction of taxpayers, an estimated 2 to 4 percent, will pay a fee because they made a choice to not obtain coverage and are not eligible for an exemption.

Americans who do not qualify for an exemption and went without health coverage in 2014 will have to pay a fee – $95 per adult or 1 percent of their income, whichever is greater – when they file their taxes this year. The fee increases to $325 per adult or 2% of income for 2015. Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.

The Administration is committed to providing the information and tools tax filers need to understand the new requirements. Part of this outreach effort involves coordinating efforts with nonprofit organizations and tax preparers who provide resources to consumers and offer on the ground support. If consumers have questions about their taxes, need to download forms, or want to learn more about the fee for not having insurance, they can find information and resources at www.HealthCare.gov/Taxes or www.IRS.gov. Consumers can also call the Marketplace Call Center at 1-800-318-2596. Consumers who need assistance filing their taxes can visit IRS.gov/VITA or IRS.gov/freefile

Consumers seeking to take advantage of the special enrollment period can find out if they are eligible by visiting https://www.healthcare.gov/get-coverage Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Assistance is available in 150 languages. The call is free.

I’ve discussed many times, most recently yesterday, how the conservative arguments against the Affordable Care Act don’t hold up. Their predictions of doom have also consistently failed to come about. Bloomberg News looked at the effect of Obamacare on corporate profits, finding only a small effect, debunking the conservative claims that Obamacare is a job killer. It also helps that one of the benefits of the Affordable Care Act has a lower increase in premiums than has been seen in the past:

The biggest entitlement legislation in a generation is causing barely a ripple in corporate America.

The Patient Protection and Affordable Care Act — otherwise known as Obamacare — is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant,” according to a Bloomberg review of conference-call transcripts and interviews with major U.S. employers.

That’s even after a provision went into effect this year requiring companies with 50 or more full-time workers to provide coverage, and after more workers are choosing to enroll in existing company coverage because of another requirement that all Americans get insured.

“It’s just part of doing business,” said Bob Shearer, chief financial officer of VF Corp., which owns the North Face and Vans apparel brands. “Obamacare has added costs, but not so much that we felt we had to talk about it specifically.”

The collective shrug from the nation’s biggest employers undermines the arguments of Republicans, who call the law a job-killer as they seek its repeal.

While U.S. health-care costs continued to rise faster than inflation in the five years since the law was passed, their rate of growth has slowed. Employers spent an average of $11,204 per worker for health benefits in 2014, up 4.6 percent from a year earlier, according to Mercer LLC. That growth rate was 6.1 percent or more each year from 1998 to 2011.

Enrollment in insurance policies purchased on the exchanges has also beaten expectations. The Hill reports, “The administration announced on Tuesday that 11.4 million people had signed up ahead of Sunday’s deadline, a figure that puts the administration on track to beat its goal of 9.1 million enrollees. Republicans have been largely silent on the numbers.”

Taken together, these two reports are further evidence that the Affordable Care Act is helping to both increase the number of people insured and restrain health care costs.

The conservative movement has become totally divorced from reality, often denying science and facts to make their positions. Here’s just three examples from the past day.

Conservatives Hate Historical Facts

Conservatives hate actual American history as the facts contradict so many of their claims. As Joseph Ellis has explained, the Founding Fathers established a secular state with overlapping sources of authority and a blurring of jurisdiction between federal and state power. Conservative claims of states’ rights and claims that the United States was founded as a Christian nation do not hold up. Oklahoma has a unique answer to teaching all those inconvenient facts in Advanced Placement History classes. Republicans there want to eliminate the AP classes and replace them classes which include the Ten Commandments and three speeches by Ronald Reagan.

Some Conservatives Still Think Obama Is A Muslim

The American Thinker is still making the conservative claim that Obama is a Muslim. Their evidence is a picture of Obama with a raised finger:

Is President Obama a Muslim? A lot has been written about this, but if photographs speak louder than words, then a photo taken at last August’s U.S.-African Leaders’ Summit in Washington D.C. might shed considerable light.

Steve M. gathered pictures of several other people who are also Muslims by this logic. The pictures include: Sarah Palin, Rush Limbaugh, Ben Carson, Scott Walker, Sean Hannity, Newt Gingrich, Andrew Breitbart, and Pam Geller. Who knew that the conservative movement was infiltrated by Muslims to this degree.

Conservatives Still Lack Any Actual Facts To Support Their Arguments Against Obamacare

Bill Maher called them Zombie Lies. Conservatives lack any real facts to dispute what a tremendous success Obamacare has become so they tell the same lies over and over, even when repeatedly proven to be lies. They are lies which just don’t die, because conservatives don’t care about facts. Jonathan Chait reviewed the latest claims from Stephen Moore, chief economist at the Heritage Foundation. See the full article to see how Chait shows that Moore’s claims are demonstrably wrong and that, “There is not a single substantive claim in this column that appears to be true.”

The Affordable Care Act has been a tremendous success in increasing the number of people insured, reducing the cost of health care coverage, and eliminating the ability of insurance companies to deny coverage to those who develop medical problems. However it is not surprising that a law of its complexity does get some details wrong. When I first heard that open enrollment would end in mid-February I thought this was a mistake.

Some of those who failed to purchase coverage last year might not realize that they risk paying penalties, and they might not realize this until around April 15 if they wait until the last minute to complete their taxes. If the goal of the mandate is to encourage people to sign up to avoid penalties, enrollment should extend through April 15. That way people could sign up for insurance to avoid the mandate.

I was glad to see that some Democrats have realized this and are working to fix the problem by urging the Obama administration to have a special enrollment period:

Three senior House members told The Associated Press that they plan to strongly urge the administration to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year.

The three are Michigan’s Sander Levin, the ranking Democrat on the Ways and Means Committee, and Democratic Reps. Jim McDermott of Washington, and Lloyd Doggett of Texas. All worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.

The lawmakers say they are concerned that many of their constituents will find out about the penalties after it’s already too late for them to sign up for coverage, since open enrollment ended Sunday.

That means they could wind up uninsured for another year, only to owe substantially higher fines in 2016. The fines are collected through the income tax system.

This year is the first time ordinary Americans will experience the complicated interactions between the health care law and taxes. Based on congressional analysis, tax preparation giant H&R Block says roughly 4 million uninsured people will pay penalties.

John Oliver and Last Week Tonight returned on HBO last weekend with a biting expose of the pharmaceutical industry (video above). Like Jon Stewart, Oliver’s comedy version of the news is far more revealing than what is seen on most actual news reports. Last Week Tonight also has the advantage of spending more time on a single story than either Jon Stewart or actual news shows.

Oliver pointed how how Americans are addicted to prescription drugs, spending almost $330 billion on them. He suggested that Walter White of Breaking Bad could have made a lot more money cooking up drugs for rheumatoid arthritis instead of meth. He lampooned the efforts of pharmaceutical companies to influence the prescribing habits of physicians, describing their ethics with this comparison: “Drug companies are a bit like high school boyfriends; they are much more concerned with getting inside you than being effective once they are in there.”

Oliver concluded with a warning about doctors who take large amounts of money from the pharmaceutical industry with a mock public service commercial, Ask Your Doctor:

Here’s how it works. Money combines with the cash receptors in your doctor’s wallet to create fast-acting financial relief, so your doctor can rest easy and enjoy life.

Common side effects of doctors taking money may include chronic overprescription, unusually heavy cash flow, dependency on free samples, inflammation of confidence, affluenza and an increased tendency to suggest off-label prescriptions, which in turn can cause heart attack, stroke, loss of feeling in arms and legs, seizures, blurred vision, grinding of the teeth, temporary deafness, total blindness, numbness, sudden bursts of rage, angry erections lasting over 17 hours, and death.

Ask your doctor today if he’s taking pharmaceutical company money. Then ask your doctor what the money is for. Ask your doctor if he’s taken any money from the companies that make the drugs he’s just prescribed for you. Then ask yourself if you’re satisfied with that answer.

The story was quite accurate. If this was a documentary as opposed to a comedy show my only complaint is that it concentrates on one side of the story in portraying doctors who take money and are susceptible to pharmaceutical sales pitches. Many doctors actually are quite aware of the problem and many do not take any meaningful amount of money from pharmaceutical companies.

For example, Oliver quoted a drug rep as being disturbed when a doctor asked her for advice on treating a patient as she is just a poli-sci major. I often feel the opposite, when pharmaceutical reps act as if they are qualified to give me advice (invariably involving greater use of their drug), knowing how little pharmaceutical or medical background most of them have. While I do accept samples in order to help out patients, which requires me to have some contact with drug reps, I am certainly not going to consider anything they say to be anything other than advertising. One time I even had a drug rep run out of my office crying when I didn’t play long with her sales pitch. We also have not been too welcoming to the rare drug rep who attempts to get back into our sample room in order to put his drugs in front and hide the samples form the competition.

Paul Waldman reminds us of some of the nutty things Rand Paul has said in the past, such as his belief in the NAFTA Superhighway conspiracy theory and past statements on the Civil Rights Act. He got in trouble again this week, along with some other Republicans, when discussing measles vaccination. It is not surprising that Paul, as is the case with the many in the Tea Party faction of the Republican Party (along with some mainstream Republicans) has a history of association with anti-vaccine groups. Paul has gone further than most other Republicans in the past in both questioning the science of vaccines and questioning the right of the state to mandate vaccinations.

Waldman has a good suggestion as to why Paul has made it to the Senate despite a history of holding views which would have prevented others from winning such a position:

But that’s not the path Rand Paul followed. Whatever his talents, he’s a United States senator because he’s Ron Paul’s son. Over his time in Congress, Ron Paul developed a small but fervent national constituency, made up of some ordinary libertarians and a whole lot of outright wackos. That constituency was greatly expanded by his 2008 presidential campaign. Despite the fact that Paul had plenty of interesting and reasonable things to say, it’s also the case that if you were building a bunker to prepare for the coming world financial crash and ensuring societal breakdown (and possible zombie apocalypse), there was only one presidential candidate for you. When Rand Paul decided to run for Senate in 2010, having never run for anything before, the Ron Paul Army mobilized for him, showering him with money and volunteers. He also had the good fortune to be running in a year when Republicans everywhere were looking for outsider, tea party candidates, so he easily beat the choice of the Kentucky GOP establishment in the primary.

You may remember that early on, and unseasoned Rand Paul got in trouble for his ideas about things like the Civil Rights Act. But he quickly discerned what was acceptable and what wasn’t, and he set about moderating his views, sanding down the rough edges of libertarianism to find something that would fit more neatly within the Republican Party while also finding issues where he could say something distinctive. It’s been very effective, but you can’t erase the past.

And I’m guessing there’s more in Paul’s past that will be of interest now that we’re getting into the 2016 campaign. I don’t mean scandalous behavior, I mean scandalous notions. I wouldn’t be at all surprised if there are a dozen more videos like this one out there, in which the now-respectable senator says some alarming things to groups of people who revere his father in all the elder Paul’s eccentric glory. I could be wrong, of course—the NAFTA superhighway and vaccines causing autism may be the only conspiracy theories Rand Paul has ever entertained. But we’re going to find out.

Rand Paul is not Ron Paul and we cannot attribute all of Ron Paul’s nuttier views and actions to Rand without evidence. I do bet that plenty more will come out if he has to face the scrutiny of a presidential campaign, and his Republican opponents for the nomination won’t hesitate to begin the opposition research.

The vaccination controversy is a twist on an old problem for the Republican Party: how to approach matters that have largely been settled among scientists but are not widely accepted by conservatives.

It is a dance Republican candidates often do when they hedge their answers about whether evolution should be taught in schools. It is what makes the fight over global warming such a liability for their party, and what led last year to a widely criticized response to the Ebola scare.

As concern spread about an Ebola outbreak in the United States, physicians criticized Republican lawmakers — including Mr. Christie — who called for strict quarantines of people who may have been exposed to the virus. In some cases, Republicans proposed banning people who had been to the hardest-hit West African countries from entering the United States, even though public health officials warned that would only make it more difficult to stop Ebola’s spread.

On climate change, the party has struggled with how to position itself, with some Republicans inviting mockery for questioning the established science that human activity is contributing to rising temperatures and sea levels.

There are two types of misinformation being spread by conservatives regarding vaccines. The most extreme is to deny the basic science, claiming that vaccines do not work or are harmful. Some limit their arguments to denying the public health dangers resulting when some people refuse to vaccinate their children, often on libertarian grounds. While herd immunity has generally protected Americans from the effects of some refusing vaccines, the current measles outbreak shows what can happen. This also highlights a major problem with libertarianism. Sometimes, as even Fox’s Megyn Kelly has argued, “some things do require some involvement of Big Brother.”

It does make it much worse for the Republicans when they show similar problems with science and facts on other issues, not limited to evolution, climate change, vaccines, and Ebola. As I discussed yesterday, Republicans are also basing their attempts to restrict abortion rights on pseudo-science, such as claiming that a fetus can feel pain before it has developed a cerebral cortex, and framing the debate around unscientific claims that there is a definite point when life begins.

While economics is not as exact a science, there is ample data which disputes Republican Voodoo Economics. Tax cuts on the wealthy do not pay for themselves, do not stimulate the economy, and do not lead to wealth trickling down. The multiplier effect of government spending on economic development, along with the benefits of giving tax breaks to the poor and middle class, as opposed to the wealthy, often provide far greater benefit. These are among the reasons that the economy does so much better under Democrats than Republicans.

We are still seeing the disastrous effects of Republicans ignoring the facts in Iraq to go to war.

Facts matter, and Republican denial of the facts do not change this. What does happen is that we all suffer when Republicans decide public policy while denying science and facts.

Republicans are increasingly seeing King v. Burwell as a way to do what they couldn’t accomplish in over fifty votes–repeal the Affordable Care Act. While it defies logic, the Supreme Court could conceivably rule that the Affordable Care Act only provides subsidies for plans purchased on state exchanges but not on the federal exchange.

A majority of people want Congress to pass a simple legislative fix should this occur, guaranteeing a continuation of the subsidies for those who purchase plans over the federal exchange. The health care and insurance industries also support such a fix.

Congressional Republicans say they won’t move to preserve consumers’ health insurance tax credits if the Supreme Court strikes them down, raising the stakes in the latest legal challenge to the Affordable Care Act…

Leaders in the GOP-controlled House and Senate see the court challenge as their best hope for tearing apart a law they have long opposed. If the court strikes down the subsidies, Democrats are expected to clamor for lawmakers to pass a measure correcting the language in the law to revive them. Congressional Republicans say there is no possibility they would allow that.

That position would force lawmakers to confront people in as many as 37 states where the federal government is currently running some or all of the exchange where consumers buy plans and tap the tax credits. There are 6.1 million people in those states who have the credits for 2015, according to federal data released this week. The average tax credit this year is $4,330, the Congressional Budget Office said this week.

Eleven of the states where the federal government has a hand in running the insurance exchange – including seven with Republican governors – signed onto a brief submitted late Wednesday asking the Supreme Court to uphold their tax credits. The brief said the loss of the credits “would deprive millions of low-and moderate-income Americans of billions of dollars in federal premium assistance essential to buy health insurance, thereby disrupting state insurance markets throughout the United States.”

The brief was filed by a group of mostly Democratic attorneys general. The lone Republican, North Dakota’s Wayne Stenehjem, declined to comment…

Nobody in the Senate Republican caucus has said the party should tweak the law so it can continue as it is, particularly since such a move would preserve the unpopular requirement for people to buy coverage or pay a fine, said Don Stewart, a spokesman for Senate Majority Leader Mitch McConnell of Kentucky.

Republicans are also increasingly preparing to use the budget procedural tactic known as reconciliation to repeal large parts of the law and potentially enact alternative provisions after the court ruling, whatever the outcome. The reconciliation process allows party leaders to pass changes with a simple majority, rather than the 60 votes most bills need to clear procedural hurdles in the Senate.

A loss of the subsidies would amount to a tax increase on the middle class. Republicans tend to concentrate on lowering taxes for the wealthy, at the expense of the middle class, and therefore see no problem in this. They mistakenly believe this will not affect their more affluent supporters, who do not qualify for the subsidies. What they fail to realize is that reducing the number of people in the risk pool will result in higher premiums for everyone.

Republicans are again talking about proposing their own plan, but they have repeatedly failed at doing so. The last time the Republicans did propose a plan it was remarkably similar to Obamacare, except then it was proposed as the conservative alternative to Hillarycare.

Any Republican plan which avoids harming millions of people will not only have to provide a mechanism for assisting those who cannot afford insurance coverage. Any plan must also ensure that insurance companies could not return to denying coverage to those who have medical problems. Republicans will find that this is not so simple, and will require the type of compromises seen in the Affordable Care Act.